1 (1-50)(51-100)(101-125) nghiên cứu ứ ứ chia N , ngang, (perforator) m da i N ứ ứ xác a N 1998 – N ứ ứ ứ N nay, i tr c 8, , ứ ứ ứ ứ N sau: ứ ứ CHƯƠ G I G C IỂM GIẢI PHẪ 1.1 I I Ộ G MẠCH MŨ ÙI GO I 1.1.1 ộ g mạc ( ù sâu ( ) ) Ngoài ứ [1],[12],[13] ộ g mạc mũ ù g ( N) [13],[39] [1],[12],[13],[39] – Nhánh lên N – Nhánh ngang ( – ) xuố g N Hình 1.1 ộ g mạc mũ ù * theo g à (2004) [13] 1.1.2 g trì g ê cứu trê t ế g N ứ [68],[71],[76],[83],[89],[96], [109] N H.D 19 ứ [91] - [125] [51] N N Hình 1.2 Dạ g gu ê ủ ộ g mạc mũ ù g t theo Senior H.D (1924) [91] N 199 J [80] 14 N (8 ) S r H.D (8 4%) Hình 1.3 Dạ g gu ê ủ (14,6%) ộ g mạc mũ ù g t P r J theo Perera J (1993) [80] 199 ( ứ Perera J [79] ) 88 N 2, ứ Hình 1.4 Dạ g gu ê ủ ộ g mạc mũ ù g t theo Perera J.(1995) [79] P r J P [33] N – 44mm Hình 1.5 ộ g mạc ù sâu c gu ê u t ộ g mạc mũ ù g g D x t D.P theo Dixit D.P (2001) [33] Lin W.W [66] g I g I cô g II ứ g III g Hình 1.6 Dạ g p â c a ộ g mạc mũ ù g I g t theo Lin W.W (2001) [66] Lin W.W ứ R.A [21] ông phát chia n : Hình 1.7 Dạ g gu ê ủ ộ g mạc mũ ù g t B rgma R.A theo Bergman R.A [21] Trong nghiên ứ [95] - N - ứ W [28] nhánh lên, ngang, - N - N - nhánh , Hình 1.8 Dạ g nguyên ủy ộ g mạc mũ ù theo Choi S.W theo Choi S.W (2007) [28] ứ [81] : 20% (6/30) 40% (12/30) Hình 1.9 Dạ g gu ê ủ 26.6%(8/30) 6.6% (2/30) 6.6% (2/30) ộ g mạc mũ ù theo Pradabsuk P theo Prabsuk P (2008) [81] N 81 [82] N 18 N N N ứ 10 B g S sá t su t xu t ộ g mạc mũ ù g g a tác g N N Dixit [33] Fukuda Choi [36] [28] Tansatit Uzel [96] [98] [82] N ứ 2001 83,3% 16,7% 2005 78,6% 21,4% 2007 86,8% 13,2% 2008 56,7% 43,3% 2008 77,3% 22,7% 2010 81,3% 18,7% N N [99] – 16cm [102] Hình 1.10 Các n ộ g mạc mũ ù theo Vuksanovic A (2006) [99] g 121 ứ , m c i m gi i ph ng m ch i N N Ic2/S (45%) N N i 6mm, 43,5% t ng s nhánh xuyên, N ) (1 2,0 – 0,7% ngang N 76, N ( ) 9mm, nhánh ng 55,8% t ng s nhánh xu ng t (81%) V m c i m gi i ph u m da t nhánh c ng m ch i N ( 720) 0,5 mm, ( xuy (trên ) 7,6 ) 122 6,7 ch xuyên 6% N ( ) , 8 123 I GH ứ ứ ứ ứ sau: -N ứ - N ứ ( p (MRIA), v.v -N ứ -N ứ ứ ) 124 - Dung PmTVt k c; 2001 s t đ i tr N i: N i; 2008 Dung PmTVt, S đ i tr c th i phu thu nh 2011;777(8):8-11 TnQc Nghiên c i ph t đ i tr N i: oh N i; 2009 nh TnBo, S n TnTt vi t ch xuyê k s t da cu ng li nh xu ng đ đ ch xuyê i nghiên c c 2011;77(6):109-14 nh TnBo, S n TnTt nh xu ađ c i ph đ nh xuyê nghiên c nh TnBo Nghiên c u s t đ i tr i g i t c 2011;77(6):91-5 i cu N i: N i; 2009 Lâm VNc Ư m ng c m t đ i tr nh t n th ng khuyt r ng phn N i; 2011 [updated 2011 15 December 2011; cited 2011]; Available from: www.benhvien108.vn t đ i tr m ng c m 10 Linh LDp Nghiên c u s ng c m YD c Lâ ng 108 2011 March 2011;6:379-85 t đ i tr N i: Vin Nghiên c 11 i cYd t vi ph thu c Lâ 13 cYd i phu ng Nam 2005;6:8-14 ng 108; 2011 u - thn kinh, th c hi c S t r ng phn m ng lâm N i; 1999 12 14 nh t n khuyt phn t da cân đ i tr c - Tp.HCM; 2004 c; 2004 oh mm c Vit 125 15 S n TnTt Nghiên c u ch thu n t ch c phu thu o di c vin Quân Y; 2003 16 nh tr iđ th nh VHu Nhn tb yu H th t mt mô m nh Tp H 17 c đu s t da cân ng niên ln XII, H i Chn Minh 2005:184-8 u cho da Phu thu nh - B môn Phu thu nh - N i; 2006 18 Adani R, Tarallo L, Marcoccio I, Cipriani R, Gelati C, Innocenti M Hand Reconstruction Using the Thin Anterolateral Thigh Flap PLASTIC AND RECONSTRUCTIVE SURGERY 2004;116(2):467-73 19 Addison PD, Lannon D, Neligan PC Compartment Syndrome After Closure of the Anterolateral Thigh Flap Donor Site: A Report of Two Cases Ann Plast Surg 2007;60:635–8 20 Alkureishia LWT, Shaw-Dunna J, Ross GL Effects of thinning the anterolateral thigh flap on the blood supply to the skin The British Association of Plastic Surgeons 2003;56:401-8 21 Bergman AR, Miyauchi R Medial and Lateral femoral circumflex Arteries [cited]; Available from: http://www.anatomyatlases.org/AnatomicVariants/Cardiovascular/Text/Arteries/FemoralC ircumflexMedLat.shtml 22 Caulfield RH, Maleki-Tabrizi A, Birch J, Ramakrishnan V Salvage of Finger Length in Septicemic Necrosis Using Free Flaps From a Single Anterolateral Thigh Donor Site Annals of Plastic Surgery 2008;60(6):623-5 23 Ceulemans P, Hofer SOP Flow-through anterolateral thigh flap for a free osteocutaneous fibula flap in secondary composite mandible reconstruction The British Association of Plastic Surgeons 2004;57:358-61 24 Chana JS, Wei F-c A review of the advantages of the anterolateral thigh flap in head and neck reconstruction The British Association of Plastic Surgeons 2004;57:603-9 126 25 Chen C-M, Chen C-H, Lai C-S, Lin S-D, Huang Y, Shieh T-Y Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects J Oral Maxillofac Surg 2005;63:948-52 26 Chen C-Y, Hsieh C-H, Kuo Y-R, Jeng S-F An Anterolateral Thigh Perforator Flap from the Ipsilateral Thigh for Soft-Tissue Reconstruction around the Knee Plastic and Reconstructive Surgery 2005.;120(2):470-4 27 Chen Z An anterolateral thigh flap based on the superior cutaneous perforator artery: An anatomic study and case reports Microsurgery 2007;27:160-5 28 Choi S-W, Park J-Y, Hur M-S, Park H-D, Kang H-J, Hu K-S, et al An Anatomic Assessment on Perforators of the Lateral Circumflex Femoral Artery for Anterolateral Thigh Flap J Craniofac Surg 2007;18(4):866-71 29 Cipriani R, Contedini F, Caliceti U, Cavina C Three-Dimensional Reconstruction of the Oral Cavity Using the Free Anterolateral Thigh Flap PLASTIC AND RECONSTRUCTIVE SURGERY 2001:53-8 30 Cunha-Gomes D, Bembde R, Bhathena H, Kavarana NM The pedicled anterolateral thigh island flap for inguinal defects Eur J Plast Surg 1999;23:97-100 31 Davidge K, Pusic A, Disa JJ, Mehrara BJ Use of the Anterolateral Thigh Flap as an Alternative to the Rectus Flap in Obese and Overweight Patients Annals of Plastic Surgery 2005;56(5):536-9 32 Demirkan F, Chen H, Wei F-C, Chen H, Jung S, Hau S, et al The versatile anterolateral thigh flap: a musculocutaneous flap in disguise in head and neck reconstruction British Journal of Plastic Surgery 2000;53:30-6 33 Dixit D, Kothari M, Mehta L Variations in the origin and course of profunda femoris J Anal Soc India 2001;50(1):6-7 34 Fan C-Y, Jiang J, Zeng B-F, Jiang P-Z, Cai P-H, Chung KC Reconstruction of Thumb Loss Complicated by Skin Defects in the Thumb–Index Web Space by Combined Transplantation of Free Tissues The Journal of Hand Surgery 2006;31A:236–41 127 35 Felixi N, Felixi A A new phalloplasty technique: the free anterolateral thigh flap phalloplasty J Plast Reconstr Aesthet Surg 2006;59:153-7 36 Fukuda H, Ashida M, Ishii R, Abe S, Ibukuro Anatomical variants of the lateral femoral circumflex artery: an angiographic study Surg Radiol Anat 2005;27(3):260-4 37 Gabrieli ER A New Electronic Medical Nomenclature Journal of Medical Systems 1989;13(6):355-73 38 Geddes C, Morris S, Neligan P Perforator flaps: Evolution, classification and applications Ann Plast Surg 2003;50:90-9 39 Gray H Anatomy: descriptive and Surgical 1995 40 Hage JJ, Woerdeman LAE Lower Limb Necrosis After Use of the Anterolateral Thigh Free Flap: Is Preoperative Angiography Indicated? 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IỂM GIẢI PHẪ 3.2 3.2.1 c m 9mm Ộ G MẠCH MŨ ÙI GO I gu ê u phân nhánh ộ g mạc mũ ù N N (8 ứ )( 1) ) g i (1 )( (1 ) N p> 0,05 Hì ộ g mạc mũ ù g tác tr c t ếp t ộ g mạc ù sâu 48 Hì ộ g mạc mũ. .. ù g xuố g ộ g mạc mũ [7] [4] Trên BN (n=20) (n=28) 3,01 cm 2,37 cm 1,2cm 2,5cm 10,1 cm (-) (n=13) 8,2 cm 6,02cm ( ) 13,50cm ( ) 21 1.3 S PH B R D C MẠCH C C NHÁNH Ộ G MẠCH MŨ ÙI GO I 1.3.1 Các... i tr c 8, , ứ ứ ứ ứ N sau: ứ ứ CHƯƠ G I G C IỂM GIẢI PHẪ 1.1 I I Ộ G MẠCH MŨ ÙI GO I 1.1.1 ộ g mạc ( ù sâu ( ) ) Ngoài ứ [1],[12],[13] ộ g mạc mũ ù g ( N) [13],[39] [1],[12],[13],[39] – Nhánh